Provider Demographics
NPI:1851083224
Name:MONCADA, MAY JEAN (LDO)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:JEAN
Last Name:MONCADA
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33501 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-5628
Mailing Address - Country:US
Mailing Address - Phone:305-242-4101
Mailing Address - Fax:305-242-4183
Practice Address - Street 1:33501 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-5628
Practice Address - Country:US
Practice Address - Phone:305-242-4101
Practice Address - Fax:305-242-4183
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6094156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician